BLADDERBULLETIN
Aswestepintoanewyear,we’reremindedthat progressisbuiltnotonlyonpersonalgoalsbuton thecollectivestrengthofacommunitythat supports,educates,andempowersoneanother. Thisyear,ourfocusremainsrootedinthepillars thatmattermost:effectivebladdermanagement, deeperdisabilityawareness,greaterindependence, andacommunitywhereeveryonefeelsseenand supported.
Bladdermanagementcontinuestobeavital partofdailyhealthanddignityformanyindividuals inourcommunity Throughsharedknowledge, practicaltools,andopenconversation,Numotion MedicalSupplyaimstomakethesechallenges easiertonavigateandlessisolating,whilealso promotinglong-termoutcomes.
Wecontinueourcommitmenttoexpanding disabilityawareness breakingdown misconceptions,amplifyinglivedexperiences,and fosteringenvironmentswhereaccessibilityisnotan afterthoughtbutastandard
Independencelooksdifferentforeveryone,and wecelebrateeveryformittakes,fromsmalldaily victoriestomajorlifemilestones.
Mostimportantly,weenterthisyearwitha reneweddedicationtobuildingacommunitywhere connectionthrives Whetheryou’reheretolearn,to share,orsimplytofeelunderstood,youbelongin thisspace.
Here’stoayearofgrowth,empowerment,and supportingoneanothereverystepoftheway
Spotlight:AbiliteaseFounder,MarkFuglevand
MarkFuglevandfoundedAbiliteasein2013todevelopadaptivesolutionsforindividuals withmobilitychallenges WhatbeganasaYouTubechanneltoadvocateforthosewith SCItransitionedtoanonlineshopfeaturing3Dprinteddevicestoassistindividualswith theiractivitiesofdailyliving Markcontinuestocreatenewdevicestoservethe community,andadvocatesforindependence.TheVOIDisproudtofeatureMarkinthis specialspotlightissue.ContinuereadingtolearnmoreaboutAbilitease!
HowdidAbiliteasecometobe...whatwasyourvisionbehindit?
Livinginthelate90swithaSpinalCordInjury(SCI)wasastruggle.Theinternetwasrelativelynew,the ADAwaslessthan10yearsold,andthereweren'talotofresourcesavailabletohelpnavigatelifewitha SCI OutpatientrehabilitationwasthebestplacetolearntipsandtricksaboutSCIfromcliniciansand otherwheelchairusers Howeveritwashardtogetinsurancecoverageforvisitsandtransportationto continuethatjourney Isoonrealizedthattherejustweren'talotofproductsandservicesoutthereto helpmebemoreindependentasaC6Incompletequadriplegic Ichoseapathofdiscoverytobeas independentaspossible,whichmeantfailingoverandovertofigurethingsout.Imadelotsoftools usingvelcro,ducttapeandmagnets.Itwasin2013afterbeinginjuredforover18yearsthatIdecidedI hadalotofideasforadaptivesolutionsandwantedtotrymakingsomeprototypesforabusiness.I cameupwiththenameAbiliteasebecauseitmeant"ease"ofability DesigningiswhatIwantedtodo forindividualslikemyselfthatwerestrugglingperformingdailytasksduetolimitedhandfunction
WhatdidyoudobeforeAbilitease?
Igraduatedfromcollegein2001withaBachelor'sdegreeinAccountingandaMastersinTaxation.Sofor thelast20plusyearsIhavebeenworkingasaCertifiedPublicAccountant.Ijoinedmywife'spracticein 2017sothatIcouldhaveamoreflexiblescheduleandspendmoretimewithmytwochildren. Abilitease wassomethingthatwasalwaysonmymind,butthetiminghadtoberight EventhoughIcreatedthe companyin2013,itwasinAugustof2022whenwelaunchedourShopifystoreandbegansellingto individualsallovertheworld IamcurrentlystillworkingasaCPAuntilIcanscaleAbiliteasetoalevel whereIcanfinanciallysupportmyfamily.
WhatwastheVERYfirstthingyou3Dprinted...howdiditturnout?!?
ThefirstthingImadewasastrawwithalittlehandleonit Iwasnewtomycomputeraideddesign (CAD)softwaresoIwatchedYouTubevideosandstartedtounderstandthebasicdesignconceptslike drawingshapesandextrudingthem OnceIprinteditoutandtoucheditIwashookedbecauseIcould seethepossibilities IguessyoucouldsaythestrawwasanearlystageUri-Luge
Youhaveafewitemsspecificallygearedtowardachievingindependencewithbladder management.Consideringthisnewsletteriscalled"TheVoid"andhasafocusonintermittent cathing,wouldyoumindsharinghowyoucametorealizetheimportanceofindependencewiththis under-addresseddailyactivity...?Whatdoessuchanindependencemeantoyou?
WhenIfirstgotinjuredIwassofocusedonparalysisandmyinabilitytowalk ItwassoonafterthatI cametounderstandallofthesecondaryconditionsthatIwasgoingtohavetomanageonadaily basis.WhenIlearnedwhataneurogenicbladderwasandhowIneededtobeabletoemptymy bladderwithacatheterIwasfrustratedandscared.IremembergettingaBARDcatheterkitwith betadineswabs,thelatexgloves,bluepadandclosedsystemcatheter Itriedperforming catheterizationusingallofthetoolsinthatkitwithmylimitedhandfunctionanditfeltimpossible Ialso hatedthesensationofhavingafullbladderwhichbroughtonflushing,headpounding,intense spasticityandsimplyfeelingincrediblyuncomfortable NottomentionwithafullbladderIhadto catheterizesoonorriskgettingurineallovermyclothing.Ascathetersgotbetterandaddressedsome ofthehanddexterityissues,Istartedtodesigntoolstoimproveuponwhatwasoutthereandtackle someoftheotherobstaclesthatIfeltstillexistedwithcatheterization.
ContactyourNumotionMedicalSupplyAccountManagerforadditionalinformation, toreceiveproductsamples,andforupcomingeducationalopportunities!
Whatisyourregiment/recipetoavoidUTIs...anytipsortricksyou'dliketoshare?
Formeit'sallaboutcleanlinesswhenperformingcatheterization SinceIusetheHollisterVaProPlus PocketCatheterthatistouchless,ImakesuretheareaaroundtheurethraiscleanusingaBZKwipe.I alsofeelitisextremelyimportanttohavearegularintermittentcatheterizationroutine.Iusedtowait hoursbeforecatheterizingwhileatworkandthiswouldoftenresultinpainfulcatheterizationand bacteriafilledurine Itisessentialtodrinkplentyoffluidsandkeepflushingyoursystemoutregularly EveryfewmonthsIbuyacontaineroforganicunfilteredfreshpressedcranberryjuiceanddrinkitover thecourseof3-4days Thisseemstohelpmakemybladderhappyinconjunctionwithdrinkinglotsof water.
Ifyouhadtolistyourtop3personalfavoriteAbiliteasedevices,whatwouldtheybe?
1:CupHolder(TrumpetStyle)-Ibringthiswithmeeverywhere Youneverknowwhenthechancemay arisetohaveacoldpintofbeer,aStarbucks,orabeverageatlunchtime
2:UrinalCap-Iusethiseverydaywithmystraightcatheters Itcomesinhandysooften
3:CanOpener-Icarrythisinmybaganduseitallofthetime
You’reanathlete,afather,andaninventor;you'veraisedafamily,startedabusiness,traveled, overcameobstacles…whatareyouMOSTproudof?
FormeI'mmostproudofmyfamilyandshowingupforthemeveryday It'sonethingtoworkhardto pushyourselfandbeindependentwithaspinalcordinjury,butit'sawholedifferentchallengebeing marriedandraisingtwokids Yourfocusshiftsandyouhavetobeemotionallyandphysicallyavailable 24/7 SoI'mproudthatIdidn'tletmydisabilitygetinthewayofhavingafamilyandcontributingdailyto theirlivelihood.Beingaparenthasbeenextremelytough,yetrewarding.
Whenyouaren’tcreatinganddevelopingforAbilitease,whatoccupiesyourtime?
OutsideofdesigningandkeepingthebusinessgoingIamafulltimeUberdriverformykid'ssports Both ofmyboysplayclubsoccerandareonmultiplefootballteams Iwouldsaythatwehaven'ttakena vacationinawhileasafamilybecausewehavesportseveryweekend Buttheboysaregrowingupfast soI'mtryingtoenjoyeverymoment.OntheoffchancewehaveafreeweekendIenjoybeinghome eitherbarbequing,listeningtomusicwithacoldadultbeverageorwatchingafunnymovie.
What'snextforAbilities?!?Anyhintsorteasers???
Iamcurrentlyparticipatinginan8weekAcceleratorprogramwithSeedSpotthatI'mveryexcited about Mybiggestholduphasbeenalackoffocusandastrategicplan Ibelievethisacceleratoris goingtopushAbiliteaseintherightdirection WehaverevampedourYouTubechannelandaremaking weeklyvideosinthehopeofreachingthe2ndtierofmonetizationsothatwecanopenaYouTubestore forAbiliteaseproducts!Iamcurrentlyworkingontworeallycoolprojectsthatinvolvecatheterization andtheEnemeezsuppository.Also,IhaveanexcitingprojectthatisgoingtokickoffsoonwiththenonprofitMakeGoodNola Staytuned!
FeaturedAdaptiveEquipment
Basedonhisownlivedexperiencesandfeedbackfromothers, MarkFuglevandhasdevelopednumerousadaptivedevicesto assistindividualswithvaryinglevelsoffunction.Fromadaptive drinkholders,creditcardgrippers,breadbagclips,andiPhone chargingcableadapters...hisdevicesimproveindependencewith dailytaskswhilealsopreservingdignity
CatheterClamp:Acatheterclampthatgivesanindividualwith limitedhanddexteritytheabilitytoholdacatheterforinsertion Thecatheterclamphasmultiplegrippositions.Youcanplaceyour fingersinoraroundthehandle,slidetheclampoveryourhandlike acuff,and/orusethepalmsofyourhandswiththeopenloop handles
UrinalCathCap:Thecustomdesignedcapssnapontothetopofa urinalandallowthecatheterusertosecuretheircatheterwhile emptyingwithoutthefearofspilling.Simplyputtheendofthe catheterinthelargeroundopeningandthenslideitdowntothe bottomofthecaptolockitintoplace
CatheterizationLapSystem:Acatheterizationlapsystemthatlies onyourlegsandwillsecureeitheryoururinalorclosedsystem bag.Thatwayyoucansafelyemptyyourbladderhandsfreeand focusonothertaskslikebrushingyourteeth!
Uri-Luge:Acatheterextensionthathooksontoyourpants,shorts orskirtandallowsyoutosecuretheendofthecatheterandempty directlyintoatoilet
LegSpreader:Alegspreadertohelpgivetheindividualwhois performingself-catheterizationaccessandvisibilitytowherethey needtoinsertthecatheter
Thisnewversionfocusedonmakingthelegspreadermore compact,discreetandfunctional Thespreaderhasadjustable armswithremovablemagneticfeet Itcomeswithasmall mountedLEDlightandamirror.
ISC:BestPracticesThroughEducation
Intermittentcatheterizationisapracticeformaintainingbladderhealththatdatesbackmorethan 3000years;however,aclinicalstandardofcareorprotocolregardingpatienteducationandproduct selectionhasnotbeendeveloped Deficitswithinastandardofpracticeincludetrainingofclinicalteam membersregardingprovidinginstructiontotheirpatients,assessmentofassistivedevices,andcriteria surroundingareferralforOTand/orPT.
In2022,aconsensuspanelofclinicalexpertswithinthefieldofurologygatheredtodevelopguidelines forbestpracticesofpatienteducationregardingintermittentcatheterization Theconsensus-based statementswerepublishedintheJournalofWound,Ostomy,andContinenceNursing,andofferan introductoryframeworktoguideproductselection,training,hygiene,follow-upcare,andmore Review theconsensusstatementsbelowforadditionalinformation!
Cleantechniqueisrecommendedforintermittentselforassistedcatheterization.
Single-usecathetersarerecommendedforselforassistedintermittentcatheterization Cathetercoatingrecommendationsshouldconsiderfriction,patientcharacteristics,comfort,and catheterizationtime
Recommendteachingofintermittentcatheterizationisbasedonanevidence-basedintermittent catheterizationprotocol.
Considerinfluenceofsocialdeterminantsofhealthoninitiatingandadheringtointermittent catheterization.
Wheninstructingselforassistedintermittentcatheterizationessentialelementsinclude(a) equipment;(b)hygiene;(c)insertion;(d)drainage;and(e)disposal
Educationshouldincluderecommendationsonpatient'spositioningbasedon(a)functionalabilities; (b)environmentalconsiderations;and(c)individual/caregiverpreferences
Duetotheriskofhypersensitivity,latex-containingcathetersarenotrecommendedforusein intermittentselforassistedcatheterization.
Theinitialfrequencyofcatheterizationisbasedonprescriberorders Frequencycanbeadjusted basedoncatheterizationvolume,individualpatientcharacteristics,complications,andshared decisionmaking
Lengthofcathetershouldbechosenbasedonurethrallengthandfunctionalabilities
Recommendcathetertipdesignbasedonspecificpatientcharacteristics(urethralobstruction, difficultyaccessingmeatus,orpassingcatheter).
Recommendeducationonappropriatefluidintakebasedonindividualpatientcharacteristicsand shareddecisionmaking Recommendpatientsbeinstructedontherelationshipbetweenfluidintake andcatheterizationvolume
Recommendroutinefollow-up(communicationorvisit)within2-4wktoreinforcecatheterization instructionanddetermineadherence Subsequentfollow-upfrequencyisbasedonindividualpatient characteristics,complications,andshareddecisionmaking.
Recommendeducationoncomplicationsofintermittentselfandassistedcatheterization,including butnotlimitedto(a)urinarytractinfections;(b)bleedingwithcatheterization;(c)difficultypassing catheter;(d)leakage(incontinence)betweencatheterizations;(e)painanddiscomfort;and(f) etiology-specificcomplications(ie,autonomicdysreflexia)
Recommendinstructingwhentoseekemergentornonemergentmedicalcarefor(a)occurrenceof complications;(b)changeincatheterizedvolume;(c)returnofspontaneousurination;and(d) cessationofintermittentcatheterization.
*Fullarticleavailableonline!
ContactyourNumotionMedicalSupplyAccountManagerforadditionalinformation, toreceiveproductsamples,andforupcomingeducationalopportunities!
AutonomicDysreflexia
Autonomicdysreflexia(AD)isamedicalemergencythatrequireseducationandselfadvocacyfor symptomstoresolve,andtopreventfurthermedicalcomplications Afteraspinalcordinjury(SCI),impaired motorandsensoryfunctionexisttovaryingdegrees.Therefore,thebodyrespondsdifferentlytoalert individualsthatsomethingiswrong.ForindividualswithanSCIatT6orabove,educationandtrainingonAD, andmanagementofAD,iscrucial Unfortunately,individualsatriskforADmaybetheonesdirectingtheir healthcareshouldanepisodeofADarise
Autonomicdysreflexiaistheresultofanynoxiousstimulibelowthelevelofinjury,suchasaningrowntoe nail,restrictiveclothing,fullbladder/bowel,andmore OneofthemostcommontriggersforADisafull bladderorissueswiththebladder,emphasizingtheimportanceofconsistentandeffectiveintermittent catheterization.
Duetovaryinglevelsofsensationandmovementafteraspinalcordinjury,anindividual’sabilitytofeel whentheirbladderisfull,ortoemptytheirbladderina“typical”wayisoftenimpacted Whenthebladder becomestoofull,ittellsthebodyinadifferentwaythatsomethingneedsattention;thebladdersendssignals thatcantriggerautonomicdysreflexia Intermittentself-catheterization(ISC)helpspreventthisbyallowing individualstoemptytheirbladderbeforeitbecomestoofull ConsistentISCcanpreventADandresolve symptomsduringanADepisode.Therefore,itiscrucialtohaveanadequatenumberofcathetersfordaily use,aswellasmanagementofpotentialADepisodes.
ForpeopleatriskofAD,healthcareprovidersoftenrecommendcatheterizingaround5to6daily, dependingonliquidintake Thisregularschedulehelpskeepthebladderatasafevolumeandreducesthe chanceofoverfilling Witheachcatheterization,it’simportanttomakesurethebladderisfullyemptied Urine leftwithinthebladder(residualurine)canresultinincreasedbladderpressure,orharborinfection-causing bacteria,andpotentiallytriggerAD.GoodhandandgenitalhygieneduringISChelpmanagetheriskofUTIs. IndividualsperformingISCneedtotakeadequatetimeandfollowtheirhealthcareprovider’sinstructions carefully.MaintainingtheoptimalISCschedule,goodhygiene,andattentiontotechniquecangreatlyreduce theriskofADwhilealsokeepingindividualshealthy
CommonsignsandsymptomsofADincludeasudden(veryintense)headache,flushedskin,sweating abovethelevelofinjury,stuffynose,orgoosebumps,allaccompaniedbyanincreaseinbloodpressure It’s importanttonote:the“newnormal”bloodpressureafteranSCIisapproximately90/60 Considertheposition inwhichbloodpressureisinitiallyassessed,BPalteringmedications,aswellastheunique“typical”BPofeach individual.ManypeopleatriskforADkeepan“ADKit”nearbyjustincaseanADepisodeoccurs.Thiskitmay includeaportablebloodpressurecuff,extracathetersandadditionalbladder/bowelsupplies,medicationsto lowerbloodpressureorforpainrelief,andADresourcesforhealthcareproviders,justincaseanADepisode occurs
Adjustingtointermittentcatheterizationtakestimeandpractice,butitdoesn’thavetostopindividuals fromlivingthelifetheywant Withtherightsupplies,somehelpfultips,andeducationforself-advocacy, individualscanmaintainbladderhealthandfeelmoreconfidentintheirdailyroutine.Ifquestionsariseor somethingdoesn’tfeelright,individualsshouldbeencouragedtotalktotheirhealthcareprovider.Each individualhastheirownlivedexperienceandshouldseekmedicaladvicewiththeirquestions,concerns, treatmentoptions,andmore
ReviewtheADemergencycardfromtheChristopherandDanaReeveFoundationonthenextpagefor informationthatcouldsavealife!
DidYouKnow...???
TheEdwinSmithPapyrus,1600-1700BC, istheoldestandmostauthenticmedicaldocumentation ofaspinalcordinjury,withtheprimaryevidencerelatingtoissueswithinthebladder.Thispapyrus, purchasedin1862byEdwinSmith,isanancientEgyptiantextthatprovidesdetailedknowledgeonthe medicaltreatmentoftraumaanddescribedSCIas“onewhohasadislocationinthevertebralcolumn ofthebackofhisneckandheisunawareofhislegsandhisarmsandhisurinedribbles:(thisis)a medicalconditionthatcannotbehealed” Sincethen,extensiveresearchhasbeencarriedout, assessmentsspecificallyrelatedtoSCIhavebeendeveloped,andsignificantclinicaltrialshave facilitatedimprovedoutcomesafterSCI.
Earlymethodsforemptyingthebladderduetoretentioninvolvedtheuseofreeds,straw,rolled palmleaves,orbronzetubes Technologyhasadvancedsignificantly,includingthedevelopmentof moresophisticatedmetalorrubbercatheters In1752,BenjaminFranklininventedthefirstflexible catheter,ultimatelychangingthetrajectoryoftreatmentforurinaryretentionfollowinganSCI Formoreinformationsurroundingbladdermanagement,SCI,andmore,checkoutNumotion’s educationalofferingsbelow!
AllyProgram
NumotionMedicalSupplyisproudtoannouncetherecentlaunchoftheAllyProgram,aninclusiveand empoweringinitiativedesignedtosupportindividualswhousecathetersinmanagingtheirbladder health.Whethernavigatinganewdiagnosisorlivingwithaconditionforyears,Allyoffersvitalresources, education,andconnectionallinoneplace
TheAllyProgramismorethanjustasupportplatform;it’sagrowingcommunitybuiltbyandfor peoplewhounderstandtheeverydayrealitiesoflifewithbladderhealthchallenges Muchofthecontent iscreatedbyNumotionMedicalSupplyaccountmanagers,wheelchairusers,andthemedicalsupply educator,ensuringthatresourcesarenotonlyclinicallysoundbutalsodeeplyrelatableandgroundedin livedexperience.
KeyFeaturesoftheAllyProgramInclude:
TheAllyPodcast:Realstoriesandauthenticconversationsaboutlivingwithcatheterizationand relatedhealthissues
LiveWebinars:Monthlyvirtualeventsfeaturingpracticalguidance,productinnovations,andQ&A sessions
DownloadableTools&Guides:Designedtomakedailylifeeasierandmoremanageable CommunityForum:Avirtualpeer-to-peercommunitywherememberscanconnect,share experiences,troubleshoot,andbuildrelationships
“Ourcustomersarelookingformorethanjustsupplies;theywanttrustedinformation,relatablestories, andconnection,”saidAmberFoster,VicePresidentofSalesatNumotionMedicalSupply “TheAlly Programwasdesignedtomeetthoseneedsbycreatingaspacethattrulysupportsthewholeperson.” “AtNumotion,webelievecommunityisapowerfulpartofcare,”addedNeillRowland,SeniorVice PresidentofNumotion’sMedicalSupplydivision “Allyrepresentsourcommitmenttowalkingalongside ourcustomerswithempathy,guidance,andresourcesthatcanmakearealdifferenceintheirlives” WiththeAllyProgram,Numotionreinforcesitscommitmenttocustomerwell-beingbyofferingnot onlyessentialproductsbutalsoatrustedsourceofknowledge,encouragement,andcommunity
TolearnmoreorjointheAllyProgram,visithttps://catheters.numotion.com/ally/.
Connecting, Supporting & Empowering
Advocate Learn Live on Your Own Terms
Benefits at a Glance
Customer Clinician
Videos focused on adaptive equipment, heplful tips, and topics surrounding ISC
Informative articles focused on best practices.
Be part of discussions and voice your thoughts through the Customer Advisory Board
Peer support community covering a broad range of topics - and an opportunity to connect with others with similar experiences and circumstances.
Access to product samples to ensure long-term functional, and healthy bladder management.
Consistent check-ins from the Numotion team to go over product satisfaction and concerns.
Videos focused on patient education and advocacy
Research articles focused on best practices
Webinars with special guests and specific, relevant topics. . and
Continuous provision of additional resources through ALLY.
Webinars with special guests focused on continuing education courses.
Be part of discussions and voice your thoughts through the Clinical Advisory Board.
Clinical peer support community focused on research and education - and an opportunity to connect with other clincians nationwide ,as necessary.
DME provider navigated
Product training
Ongoing customer support
onfeatures and benefits via regular check-ins.
Monthly detailed progress reporting
Ability to quantify customers served qualify customer satisaction.
Assess long-term functional outcomes.
ALLY CLINICAL ADVISORY BOARD
Come be a part of like-minded professionals, eager for collaboration to empower patients and clinicians across the country!
